Individual provider Active NPI

Jennifer Reyes

  • Rehabilitation Practitioner
  • Grand Terrace, CA
National Provider Identifier
1801584172
Registry record updated Jul 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation PractitionerTaxonomy code 225400000X
Practice address
21935 Van Buren St Ste B-13
Grand Terrace, CA 92313-5652
Phone
(909) 906-1023
NPI assigned
Apr 25, 2023
Last updated
Jul 27, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 27, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X
Rehabilitation Practitioner 225400000X Primary

Addresses

Primary practice location

21935 Van Buren St Ste B-13
Grand Terrace, CA 92313-5652

Mailing address

21935 Van Buren St Ste a-1
Grand Terrace, CA 92313-5652
Phone (909) 906-1023

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
The Heart Matters Foster Family Agency CurrentSince Apr 30, 2023 Accepting new patients
The Heart Matters Foster Family Agency CurrentSince Apr 30, 2023 Accepting new patients

Locations

21935 Van Buren St
Ste A1
Grand Terrace, CA 92313
Phone (909) 906-1023

21935 Van Buren St
Ste B13
Grand Terrace, CA 92313
Phone (909) 906-1023

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1682380800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690416000000",
    "number": "1801584172",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21935 VAN BUREN ST STE A-1",
            "city": "GRAND TERRACE",
            "state": "CA",
            "postal_code": "923135652",
            "telephone_number": "909-906-1023"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21935 VAN BUREN ST STE B-13",
            "city": "GRAND TERRACE",
            "state": "CA",
            "postal_code": "923135652",
            "telephone_number": "909-906-1023"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REYES",
        "first_name": "JENNIFER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-04-25",
        "last_updated": "2023-07-27",
        "certification_date": "2023-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225400000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Practitioner",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Terrace, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.